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Appendix 2: Tables

SNAC-recommended Initial Core Set, September 18, 2009

Table A: Measures that Met the Criteria Thresholds for Validity, Feasibility, and Importance But Were Not Recommended for Inclusion in the Core Set

Internal SNAC/AHRQ Control #Measure Label
Prevention and Health Promotion
Prenatal/Perinatal
PHP-3Smoking Cessation and Prevention: Pregnant women
PHP-26BHRSA MCH Health Status Indicator #01B—% of live singleton births weighing less than 2,500 gms
PHP-26CHRSA MCH Health Status #02A—% of live births weighing less than 1500 gms
PHP-26DHRSA MCH Health status #02B—% of live singleton births weighing less than 1500 gms
PHP-31MCHB National performance measure #8—the rate of birth (per 1,000) for teenagers aged 15-17 years
PHP-32Proportion of infants 22-29 weeks gestation treated with surfactant who are treated within 2 hours of birth
PHP-34Health systems capacity indicator #04-% of women 15-44 with a live birth during the year whose observed to expected prenatal visits are greater than or equal to 80% on the Kotelchuck Index
PHP-36ARate of elective delivery prior to 39 completed weeks gestation
Immunizations
PHP-5BTwo-year-old Immunization Measure—Assessing immunizations by timeliness and the ACIP/AAP/CDC schedule versus HEDIS dose counting (OR)
General Screening
PHP-17Newborn Hearing Screening
PHP-18Vision screening—use MEPS description and performance data
Social/Behavioral Health Screening
PHP-33AAdministration of SDBS (Standardized screening tools social and emotional (CMWF/CAHMI))
Dental/Oral Health
PHP-42Total eligibles receiving any dental services (EPSDT measure Line 12A)
PHP-43AHRSA Oral Health Measures WG Measure—% of children age 12-72 mos with 1 or more fluoride varnish apps documented
Management of Acute Conditions
Acute Upper Respiratory Tract Illness
AC-1Upper respiratory infection—appropriate treatment
Acute Otitis Externa
AC-11Acute Otitis Externa—Topical therapy
AC-13Acute Otitis Externa—Systemic antimicrobial therapy-avoidance of inappropriate use
Otitis Media with Effusion
AC-14OME Diagnostic evaluation—assessment of tympanic membrane mobility
AC-18OME—systemic corticosteroids—avoidance of inappropriate use
Inpatient Care
AC-5Foreign body left after procedure (PDI 3)
AC-6Iatrogenic pneumothorax in non-neonates (PDI)
AC-20Care transitions—transition record with specified elements received by discharged patients—Inpatient
AC-23Central line associated bloodstream infection (PDI 12)
AC-24Accidental puncture and laceration
AC-25Decubitus ulcer
AC-26AHRQ Pediatric Quality Indicator Composite Measure (Patient Safety Composite)
ED Care
AC-21Care transition—transition record with specified elements reviewed by discharged patients-ED
Management of Chronic Conditions
Mental and Behavioral Health/Substance Use
ADHD Care
CC-1Followup care for children prescribed attention-deficit/hyperactivity disorder (ADHD) medication (Initiation Phase; NCQA measure)
HIV
CC-8AHIV/AIDS Bureau quality performance measure—percentage of clients with AIDS who are prescribed HAART
CC-23HIV AIDS Bureau Measure—% of clients with HIV infection who had two or more CD4 T-cell counts performed in the measurement year
CC-24HRSA HIV/AIDS QPR % of clients with HIV who had two or more medical visits in an HIV setting in the measurement year
Asthma
CC-10Asthma — appropriate medications
CC-10BUse of Appropriate Medications for People 5-20 years of age with Asthma – Average number of member controller months
CC-18Annual influenza vaccination (all children and adolescents diagnosed with asthma)
CC-20Annual number of asthma patients (>1 year old) with >1 asthma-related hospitalization
Diabetes
CC-14Annual lipid profile (adolescents with diabetes >16 years old)
CC-16Annual eye examination (adolescents with diabetes >16 years old)
CC-17Annual influenza vaccination (all children and adolescents diagnosed with diabetes)
End-Stage Renal Disease
CC-33Pediatric end-stage renal disease—Plan of care for inadequate hemodialysis
CC-34Pediatric end-stage renal disease—influenza immunization
Duration of Enrollment
D-2Retrospective duration measure

Source: AHRQ, based on SNAC Delphi II scoring and September 17-18, 2009, SNAC meeting.

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Table B: Measures that Did Not Meet Criteria Thresholds for Scoring on Validity, Feasibility, and Importance

Control NumberMeasure Label
PREVENTION AND HEALTH PROMOTION
Prenatal/Perinatal
PHP-1AHRSA MCH MPR #18—% of infants born to pregnant women receiving prenatal care beginning in the first trimester (data source—nvss—differs from NCQA; Medicaid/CHIP specific not available from NVSS.
PHP-26Percentage of low birth weight (PDI—hospital discharge data)
PHP-27Postpartum care visit NCQA measure
PHP-30MCHB National performance measure #17—percent of VLBW infants delivered at facilities for high-risk deliveries and neonates
PHP-30AUnder 1500g infant Not Delivered at Appropriate Level of Care
PHP-36Elective delivery prior to 39 weeks gestation
PHP-40HRSA MCH NPR MEASURE #11—% of mothers who breastfeed their infants at 6 mos of age
PHP-41HRSA MCH NPR #15—% of women who smoke in the last 3 months of pregnancy
Immunizations
PHP-8Immunization reporting (provider registry)
Adolescent Preventive Services
PHP-11Adolescent Well-Care Visits (NCQA)
PHP-15Adolescent receipt of the following seven components of care during the measurement year: BMI percentile, assessment/counseling/education on nutrition, physical activity, risk behaviors associated with sexual health/activity/preventive actions, depression screening
PHP-16Smoking Cessation and Prevention: adolescent tobacco users
General Screening
PHP-19Weight Assessment and Counseling for Nutrition and Physical Activity for children and adolescents
PHP-19BNutrition counseling—NCQA
PHP 19CPhysical Activity Counseling (NQCA)
PHP-29Lead screening rate (NCQA—1st year measure—see confidential data); note USPSTF recommendation
PHP-29ALead screening 2nd year—% of members who turned age 2 during the reporting period and received a lead test (data from MaineCare claims and the Maine CDC)
PHP-29BLead screening 1st year—% of members who turned age 1 during the reporting period and received a lead test (data from MaineCare Claims and Maine CDC)
PHP-29CHRSA Lead screening in children by 2 years of age (data source differs from NCQA)
PHP-39EPSDT—Percentage of members 0-20 years old who had one or more EPSDT procedure(s) during the reporting period
Social/Behavioral Health Screening
PHP-37Percent of members under age 21 with a WCC visit by any provider during the measurement period who had a BH screen.
Dental/Oral Health
PHP-22AHRSA oral health measure—the percentage of patients who had at least one dental visit during the measurement year (differs from NCQA—data source is CHCs; broader age range)
PHP-35HRSA oral health measure — percentage of all dental patients with a comprehensive or periodic recall oral exam within a 12 month period
MANAGEMENT OF ACUTE CONDITIONS
Acute Otitis Externa
AC-12Acute Otitis Externa—Pain Assessment
Otitis Media with Effusion
AC-15Otitis Media with Effusion—Hearing testing
Dental
AC-8HRSA oral health measure—percentage of all dental patients for whom the Phase I treatment plan is completed within a 12-month period
AC-9HRSA oral health performance measure—percentage of all dental patients with a comprehensive or periodic recall oral exam, for whom the Phase I treatment plan is documented
Inpatient Care
AC-7PICU pain assessment on admission
AC-19Care transitions—reconciled medication list received by discharged patients
AC-22Care transitions—timely transmission of transition record (from input)
ED Care
AC-10ER Utilization - Average number of emergency room visits per member per reporting period
AC-21Care transition—transition record with specified elements received by discharged patients-ED
MANAGEMENT OF CHRONIC CONDITIONS
Mental and Behavioral Health/Substance Use
ADHD Care
CC-6Diagnosis of ADHD in primary care for school age children and adolescents (using DSM)
Depression Care
CC-27Child and adolescent Major Depressive Disorder (MDD)—interview of adolescent or child
CC-28Child and adolescent Major Depressive Disorder(MDD)—diagnostic evaluation
CC-30Child and adolescent Major Depressive Disorder (MDD)—psychotherapy
CC-32Child and adolescent Major Depressive Disorder (MDD)—follow-up care
Other Mental Health/Behavioral Care
CC-4Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (ages 3-17 and 18+)
CC-35Medication adherence as measured by maximal gaps in days during a calendar year for ADHD and anti-psychotics medication in children
Children with Special Health Care Needs
CC-37CSHCN number of missed school days due to illness or injury
HIV
CC-8Highly active anti-retroviral treatment
Asthma
CC-25Percentage of patients for whom there is documentation that a written asthma management plan was provided to the patient or the patient's caregiver OR at minimum instructions on under what conditions the patient's doctor should be contacted or the patient should go to the emergency room.
Chronic Disease Identified through Newborn Screening
CC-12Timely follow-up of positive newborn screens
Diabetes
CC-15Annual urine protein screening (adolescents with diabetes > 16 years-old)
CC-21Hemoglobin A1c test for pediatric patients
FAMILY EXPERIENCES WITH CARE
Other Family/Patient Experiences of Care Measures
FEC-2Helpfulness of counseling (adolescent reported)
FEC-3Communication and experience of care (adolescent reported)
FEC-4Dental CAHPS® (overall ratings of dentist, dental plan, dental care, office staff)
MOST INTEGRATED HEALTHCARE SYSTEMS
MIH-2Medical home measure using subset of HEDIS CAHPS® MEDICAID 4.0 survey items
AVAILABILITY OF SERVICES
AV-1Unduplicated members served per provider
Use of Services
US-1Utilization of ambulatory services
US-2Outpatient drug utilization—per member per year average number of prescriptions
US-3Utilization of inpatient care
Access to Services
HEALTH STATUS
HS-2PROMIS Pediatric item Banks: physical function, emotional distress, social role relationship, fatigue, pain, and asthma
DURATION OF ENROLLMENT
D-1Prospective duration measure

Key:
V = Validity
F = Feasibility
I = Importance
IQR = Inter-Quartile Range
N = Number of Subcommittee members rating measure

Current as of January 2010
Internet Citation: Appendix 2: Tables: SNAC-recommended Initial Core Set, September 18, 2009. January 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/policymakers/chipra/coreset/coresetap2.html